Glenn Rex McClellan, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA00707 Issued in TX

Practice address

125 South Park Drive
Ste B
Brownwood, TX 76801

Phone

(325) 643-5445

Fax

(325) 643-5447

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Strefling Orthopaedic Surgery, PA

  • Orthopaedic Surgery Physician
  • Brownwood, TX
  • NPI 1518137074
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1356436182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SOUTH PARK DRIVE",
            "address_2": "STE B",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "76801",
            "telephone_number": "325-643-5445",
            "fax_number": "325-643-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SOUTH PARK DRIVE",
            "address_2": "STE B",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "76801",
            "telephone_number": "325-643-5445",
            "fax_number": "325-643-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "GLENN",
        "middle_name": "REX",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA00707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saul Martinez, DNP, CRNA
• John Patrick Masterson, M.D.
• Terri Tobias Mathis, MS CCC.SLP
• Mallorie Ann Maxwell
• Christi McCarty
• Steven Harry McCrane, PT
• Tammy P. McCullough, FNP-C
• Henry Wilcox McGowen II, M.D.
• Charley Kennon McLean, DDS
• Amber Elizabeth McMillian, CCC-SLP

• Surgical Physician Assistant in Brownwood, TX
• Providers in Brownwood, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.